Fragility assessment in primary care: which tools for predicting what?

Abstract

Frailty is a geriatric syndrome associated with high risk for falls, disability, hospitalization, and mortality. The aim of this study is to assess the prevalence of frailty to the Fried's criteria in primary care and its evolution and the outcome of the patients at 1 year. Descriptive prospective study of patients over 75 years coming consult three general practitioners, evaluated initially and at 1 year. Frailty was defined by the presence of three criteria including weight loss, weakness (grip strength), self-reported exhaustion, low physical activity and slow walking speed. Of the 55 patients re-evaluated, 10.9% of patients were frail, 56.4% pre-frail and 32.7% were robust. Robust who become frail during the initial assessment, had a lower IADL score (p = 0.004) and a lower grip strength (p = 0.0311) than those who remained robust. Fried tool is difficult to implement in primary care. Grip strength and IADL are interesting for a simple screening tool in general practice to allow early treatment and delay progression to addiction.